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How Do You Diagnose Diabetic Retinopathy?

Lighthouse International - Diabetic Retinopathy Diagnosis

Lighthouse International - Diabetic Retinopathy Diagnosis

You've come a long way, baby. Thirty years ago, your chances of going blind within five years of being diagnosed with severe diabetic retinopathy were no better than 50/50. Today, the same diagnosis gives you a 90% chance of saving your sight. There's just one little catch: If you have type 1 or type 2 diabetes (visit What is Diabetic Retinopathy to learn about the differences) you must have a comprehensive dilated eye examination every year even if you have no symptoms. Preserving your sight is a gamble that depends more on strategy than on luckbut it's a game you simply must not walk away from. Remember, adults and children age 10 and older who have diabetes should have a comprehensive dilated eye examination every year even if they have no symptoms. An immediate eye exam is in order if you recognize yourself below: You've had Type 1 diabetes for a year or more and have not had an exam in over a year You have Type 2 diabetes and have not had an exam in a year or longer You have a child with diabetes who has reached puberty You're pregnant or are planning to become pregnant and have diabetes The Retasure retinal imaging device is a new tool that allows you to be screened for diabetic retinopathy at a primary care physician's office. The device takes a quick, painless digital photo of the macula and optic nerve. This photo is transmitted via a secure network to an ophthalmologist at an accredited reading center. Results are available within a few days, and you'll be referred to an ophthalmologist for a complete examination and possible treatment if signs of retinopathy are discovered. However, the Retasure network is limited to several hundred primary care offices that subscribe to the service and have the necessary camera and hardware on the premises; unless you live Continue reading >>

Diabetic Retinopathy Diagnosis

Diabetic Retinopathy Diagnosis

Diabetic retinopathy may present with little or no symptoms in the early stages of disease. Diabetics with more long-term disease may develop symptoms and, eventually, irreversible damage to the retina may occur. Diabetic retinopathy therefore needs to be diagnosed early on in diabetic patients and routine screening and monitoring is of vital importance in order to preserve vision among these individuals. New retinal imaging scanner may one day revolutionize eye care The blindness that can eventually be caused by diabetic retinopathy cannot be reversed. Diabetics who are aged 12 years or over need to attend annual checks for the condition. If diabetic retinopathy is detected in the early stages, it can be treated using laser treatment. For screening, the pupils of the eyes are dilated using certain medicated eye drops and photographs of the retina are then taken. The eye drops may cause blurring of vision for around 5 to 6 hours depending on the type of drops used. For diagnosis of diabetic retinopathy to be confirmed, several tests are employed: Visual acuity is tested by assessing a person's ability to read a chart displaying random letters and numbers at various distances. Ophthalmoscopy or fundoscopy is performed to look inside the fundus of the eye and determine retinal health. A device called an ophthalmoscope contains a light and a special magnifying glass for examining the fundus. Optical coherence tomography is a type of visualization technique that provides high resolution images of retinal structures. The layers of the retina can be differentiated and retinal thickness can be determined. Slit lamp biomicroscopy is an important diagnostic technique for examining anterior eye structures and the retina at variable magnifications. Fluorescein angiography is perf Continue reading >>

Diabetic Retinopathy

Diabetic Retinopathy

On this page: Diabetes and diabetic retinopathy • DR symptoms • Types of diabetic eye disease • Who gets diabetic retinopathy? • Minorities and diabetic eye disease • When is DR a disability? • Eye exam assistance program • Prevention • Diabetic retinopathy videos Diabetic retinopathy — vision-threatening damage to the retina of the eye caused by diabetes — is the leading cause of blindness among working-age Americans. The good news: Diabetic retinopathy often can be prevented with early detection, proper management of your diabetes and routine eye exams performed by your optometrist or ophthalmologist. According to the International Diabetes Federation (IDF), the United States has the highest rate of diabetes among 38 developed nations, with approximately 30 million Americans — roughly 11 percent of the U.S. population between the ages of 20 and 79 — having the disease. About 90 percent of Americans with diabetes have type 2 diabetes, which develops when the the body fails to produce enough insulin — a hormone secreted by the pancreas that enables dietary sugar to enter the cells of the body — or the body becomes resistant to insulin. This causes glucose (sugar) levels in the bloodstream to rise and can eventually damage the eyes, kidneys, nerves or heart, according to the American Diabetes Association (ADA). Risk factors for type 2 diabetes include obesity, an unhealthful diet and physical inactivity. Unfortunately, the prevalence of obesity and type 2 diabetes has increased significantly in the United States over the past 30 years. According to data released by the U.S. Centers for Disease Control and Prevention (CDC) in December 2015, there were 1.4 million new cases of diabetes reported in the U.S. in 2014. Though this annual number is d Continue reading >>

How To Diagnose Diabetic Retinopathy - Retina Specialist | Fairfax, Virginia | Retinal Diseases

How To Diagnose Diabetic Retinopathy - Retina Specialist | Fairfax, Virginia | Retinal Diseases

The retina is the only part of the eye affected by diabetes. The only way to diagnose diabetic retinopathy is by direct visualization of the retina. Your eye doctor should be able to dilate your eyes and, by simply looking at your retina, diagnose the disease. Thats all. Symptoms are the effects of a disease. These are what a patient feels, not what a doctor sees. Complaints of blurry vision, pain, shortness of breath, nervousnessall are types of symptoms. The disease, diabetic retinopathy, can cause mild blurriness to complete blindness, or nothing at all. Many patients see perfectly, yet have the disease. They just dont know it. This is the danger of diabetic retinopathy. Just like high blood pressure, it may cause absolutely no symptoms. A normal eye exam does not always include dilation of the pupils. Every diabetic patient must have the pupils dilated at least annually. These are the recommendations of the American Academy of Ophthalmology and the American Optometric Association. Why? A dilated exam is the only way to examine the retina. A dilated exam is the only way your doctor can see the characteristic changes of diabetic retinopathy. There are no diagnostic tests for diabetic retinopathy. In the absence of symptoms, the diabetic retinopathy can still be diagnosed. Early detection means preventing loss of vision. Fluorescein angiography and OCT ( optical coherence tomography ) are used commonly to study some of the aspects of your retina (i.e. is there retinal swelling?), but neither are necessary for the diagnosis. The only way to diagnose diabetic retinopathy is for somone to see it. What Does This Mean? Diabetic eye disease can be silent. Many people believe that the absence of symptoms means the absence of disease. Obviously not true. The patients with who Continue reading >>

Diabetic Retinopathy - Exams And Tests

Diabetic Retinopathy - Exams And Tests

Diabetic retinopathy can be detected during a dilated eye exam by an ophthalmologist or optometrist. An exam by your primary doctor, during which your eyes are not dilated, is not an adequate substitute for a full exam done by an ophthalmologist. Eye exams for people with diabetes can include: Visual acuity testing. Visual acuity testing measures the eye's ability to focus and to see details at near and far distances. It can help detect vision loss and other problems. Ophthalmoscopy and slit lamp exam. These tests allow your doctor to see the back of the eye and other structures within the eye. They may be used to detect clouding of the lens (cataract), changes in the retina, and other problems. Gonioscopy. Gonioscopy is used to find out whether the area where fluid drains out of your eye (called the drainage angle) is open or closed. This test is done if your doctor thinks you may have glaucoma, a group of eye diseases that can cause blindness by damaging the optic nerve. Tonometry. This test measures the pressure inside the eye, which is called intraocular pressure (IOP). It is used to help detect glaucoma. Diabetes can increase your risk of glaucoma. Your doctor may also do a test called an optical coherence tomography (OCT) to check for fluid in your retina. Sometimes a fluorescein angiogram is done to check for and locate leaking blood vessels in the retina, especially if you have symptoms, such as blurred or distorted vision, that suggest damage to or swelling of the retina. Fundus photography can track changes in the eye over time in people who have diabetic retinopathy and especially in those who have been treated for it. Fundus photography produces accurate pictures of the back of the eye (the fundus). An eye doctor can compare photographs taken at different ti Continue reading >>

Facts About Diabetic Eye Disease

Facts About Diabetic Eye Disease

Points to Remember Diabetic eye disease comprises a group of eye conditions that affect people with diabetes. These conditions include diabetic retinopathy, diabetic macular edema (DME), cataract, and glaucoma. All forms of diabetic eye disease have the potential to cause severe vision loss and blindness. Diabetic retinopathy involves changes to retinal blood vessels that can cause them to bleed or leak fluid, distorting vision. Diabetic retinopathy is the most common cause of vision loss among people with diabetes and a leading cause of blindness among working-age adults. DME is a consequence of diabetic retinopathy that causes swelling in the area of the retina called the macula. Controlling diabetes—by taking medications as prescribed, staying physically active, and maintaining a healthy diet—can prevent or delay vision loss. Because diabetic retinopathy often goes unnoticed until vision loss occurs, people with diabetes should get a comprehensive dilated eye exam at least once a year. Early detection, timely treatment, and appropriate follow-up care of diabetic eye disease can protect against vision loss. Diabetic retinopathy can be treated with several therapies, used alone or in combination. NEI supports research to develop new therapies for diabetic retinopathy, and to compare the effectiveness of existing therapies for different patient groups. What is diabetic eye disease? Diabetic eye disease can affect many parts of the eye, including the retina, macula, lens and the optic nerve. Diabetic eye disease is a group of eye conditions that can affect people with diabetes. Diabetic retinopathy affects blood vessels in the light-sensitive tissue called the retina that lines the back of the eye. It is the most common cause of vision loss among people with diabetes Continue reading >>

Diabetic Retinopathy

Diabetic Retinopathy

Diabetic retinopathy is caused by changes in the blood vessels of the retina. When these blood vessels are damaged, they may leak blood and grow fragile new vessels. When the nerve cells are damaged, vision is impaired. These changes can result in blurring of your vision, hemorrhage into your eye, or, if untreated, retinal detachment. Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in the United States. What Is Diabetic Retinopathy, Testing, and Treatments Watch these video animations to learn more about diabeticretinopathy, the affect that the diabetic retinopathy has on the eyes,and tests and treatments options for the condition. The symptoms described above may not necessarily mean that you have diabetic retinopathy. However, if you experience one or more of these symptoms, contact your ophthalmologist for a complete exam. It is also important to note that pregnancy and high blood pressure may aggravate diabetic retinopathy. People with untreated diabetes are 25 times more at risk for blindness than the general population. The longer a person has had diabetes, the higher the risk of developing diabetic retinopathy. Fortunately, with regular, proper eye care and treatment when necessary, the incidence of severe vision loss has been greatly reduced. If you have diabetes, your ophthalmologist can help to prevent serious vision problems. Diabetic retinopathy can cause vision loss in two ways: Macular Edema Macular edema is a condition where your retinal blood vessels develop tiny leaks. When this occurs, blood and fluid leak from the retinal blood vessels and fatty material (called exudate) is deposited in the retina. This causes swelling of the retina and is called diabetic macular edema. When this swelling occurs in the ce Continue reading >>

Diabetes Discovery – Via The Eyes

Diabetes Discovery – Via The Eyes

Did you know that an eye exam can be the first clue to detecting diabetes and other hidden health concerns? Finding health issues early can give patients a better chance at preventing damage through early treatment and management. A routine eye exam can show so many things. Some can be downright life changing – and life-saving – for that matter. One doctor found out first-hand when she did the same thing she does every day – she looked into a patient's eyes. But this was no ordinary exam. When Kathleen Clary, OD, peered into her 48-year-old patient’s eyes, she saw blood and other fluids seeping out of fragile and miniscule vessels in her retinas. The retina is the light and sight-sensing back part of the eye – and without it, you don't see. “As soon as I noticed the leaking fluids and the hemorrhaging, I suspected that they might be symptoms of diabetes,” recalls Dr. Clary, who practices in the Washington, D.C., suburb of Ashburn, Virginia. “In my 12 years of experience as an eye doctor, that kind of bleeding usually signals that a buildup of sugar in the patient’s bloodstream has begun to break down the capillaries that feed the retina. The result is often what we call diabetic retinopathy – a condition in which continuing damage to retinal tissue from diabetes can lead to impaired vision or even blindness, if left untreated.” The eye exam was the very first clue the patient had that she might have diabetes. Dr. Clary talked with her patient about what she saw and explained what it could mean. “I want you to have your blood sugar level checked right away by your family doctor,” she told her patient. “Tell the doctor you need to be evaluated for diabetes with a fasting blood sugar test, because your optometrist noticed some retinal bleeding. Continue reading >>

Early Diagnosis Of Diabetic Retinopathy In Primary Care

Early Diagnosis Of Diabetic Retinopathy In Primary Care

Early diagnosis of diabetic retinopathy in primary care Diagnstico temprano de retinopata diabtica en el primer nivel de atencin 1 Coordinacin Auxiliar de Investigacin en Salud, IMSS Quintana Roo, Cancn, Mexico 6 Clinical and epidemiological research group of Instituto Mexicano del Seguro Social in Quintana Roo. Cancn, Mexico Find articles by Maria Valeria Jimenez-Baez 2 Servicio de Cardiopatas Congnitas, Hospital de Cardiologa, Centro Mdico Nacional Siglo XXI, IMSS, Mxico, Distrito Federal. 6 Clinical and epidemiological research group of Instituto Mexicano del Seguro Social in Quintana Roo. Cancn, Mexico Find articles by Horacio Marquez-Gonzalez 3 Instituto Mexicano del Seguro Social, Hospital Gineco Pediatra No. 07. Cancn Quintana Roo, Mexico 6 Clinical and epidemiological research group of Instituto Mexicano del Seguro Social in Quintana Roo. Cancn, Mexico Find articles by Rodolfo Barcenas-Contreras 4 Servicio de Oftalmologa, Hospital Regional No 17, Instituto Mexicano del Seguro Social Quintana Roo. Cancn, Mexico 6 Clinical and epidemiological research group of Instituto Mexicano del Seguro Social in Quintana Roo. Cancn, Mexico 5 Hospital General de Zona No. 3. Instituto Mexicano del Seguro Social Quintana Roo. Cancn, Mexico 6 Clinical and epidemiological research group of Instituto Mexicano del Seguro Social in Quintana Roo. Cancn, Mexico Find articles by Laura Fatima Espinosa-Garcia 1 Coordinacin Auxiliar de Investigacin en Salud, IMSS Quintana Roo, Cancn, Mexico 2 Servicio de Cardiopatas Congnitas, Hospital de Cardiologa, Centro Mdico Nacional Siglo XXI, IMSS, Mxico, Distrito Federal. 3 Instituto Mexicano del Seguro Social, Hospital Gineco Pediatra No. 07. Cancn Quintana Roo, Mexico 4 Servicio de Oftalmologa, Hospital Regional No 17, Instituto Mexicano del Segu Continue reading >>

Diabetic Retinopathy

Diabetic Retinopathy

Retinal consequence of chronic progressive diabetic microvascular leakage and occlusion. Etiologic factors include hyperglycemia, hypertension, and possibly genetic factors. Sight-threatening signs include macular edema, retinal or optic disc new vessels, and vitreous hemorrhage. Main goals of therapy are to improve glycemic, lipid, and hypertensive control and ensure that sight-threatening disease is arrested before visual loss occurs. Diabetic retinopathy is the retinal consequence of chronic progressive diabetic microvascular leakage and occlusion. It eventually occurs to some degree in all patients with diabetes mellitus. There are two types: nonproliferative and proliferative. Nonproliferative diabetic retinopathy (NPDR) is the early stage of the disease and is less severe. Blood vessels in the eye may leak fluid into the retina, which leads to blurred vision. Proliferative diabetic retinopathy (PDR) is the more advanced form of the disease. New blood vessels start to grow in the eye (neovascularization), which are fragile and can hemorrhage. This may cause vision loss and scarring of the retina. [Figure caption and citation for the preceding image starts]: Nonproliferative diabetic retinopathy: exudate (yellow arrow), microaneurysms (red arrow), cotton wool spot (white arrow), nerve fiber layer hemorrhage (green arrow) Courtesy of Moorfields Photographic Archive; used with permission [Citation ends]. [Figure caption and citation for the preceding image starts]: Proliferative diabetic retinopathy: new vessels on the optic disk (red circle) Courtesy of Moorfields Photographic Archive; used with permission [Citation ends]. Continue reading >>

What To Expect At Your Eye Exam

What To Expect At Your Eye Exam

If you are lucky enough to have good eyesight, you may be surprised when your diabetes care team recommends that you make an appointment with an eye doctor. If your vision is stable, and your eyes don’t bother you, why should you have your eyes checked? The answer is that many potentially devastating eye problems develop without causing discomfort or distorting vision. Glaucoma and cataract are examples of eye problems that occur commonly in older adults and more frequently in people with diabetes. Generally, these conditions are treatable, but if not caught early enough, they can lead to vision loss or even blindness. In addition, there’s diabetic retinopathy, a serious complication that is more likely to occur in people with Type 1 diabetes but may develop in anyone with diabetes. Tight blood glucose control can significantly reduce the incidence and severity of diabetic retinopathy, but the only way to identify this and other eye problems in their earliest and most treatable stages is to have regular, comprehensive eye examinations. -- Keep an eye on your vision! Learn about preventive steps and treatments for diabetic retinopathy from retinal specialist Dr. Charles Wykoff. >> There’s no reason to avoid an eye exam; it involves a series of painless tests that check your visual acuity and general eye health and screen for signs of disease. Before we discuss what to expect at the exam, let’s take a look at the eye and how it works. The eye The eye is a hollow organ about the size of a Ping-Pong ball, with an opening at the front that lets in light, and a gelatinous substance called vitreous filling most of the inside. It functions in a manner similar to a camera. The aperture through which light enters the eye is the pupil, the black-seeming hole in the middle Continue reading >>

Diabetic Retinopathy

Diabetic Retinopathy

Practice Essentials Diabetes mellitus (DM) is a major medical problem throughout the world. Diabetes causes an array of long-term systemic complications that have considerable impact on the patient as well as society, as the disease typically affects individuals in their most productive years. [1] An increasing prevalence of diabetes is occurring throughout the world. [2] In addition, this increase appears to be greater in developing countries. The etiology of this increase involves changes in diet, with higher fat intake, sedentary lifestyle changes, and decreased physical activity. [3, 4] Patients with diabetes often develop ophthalmic complications, such as corneal abnormalities, glaucoma, iris neovascularization, cataracts, and neuropathies. The most common and potentially most blinding of these complications, however, is diabetic retinopathy, [5, 6, 7] which is, in fact, the leading cause of new blindness in persons aged 25-74 years in the United States. Approximately 700,000 persons in the United States have proliferative diabetic retinopathy, with an annual incidence of 65,000. An estimate of the prevalence of diabetic retinopathy in the United States showed a high prevalence of 28.5% among those with diabetes aged 40 years or older. [8] (See Epidemiology.) The exact mechanism by which diabetes causes retinopathy remains unclear, but several theories have been postulated to explain the typical course and history of the disease. [9, 10] See the image below. In the initial stages of diabetic retinopathy, patients are generally asymptomatic, but in more advanced stages of the disease patients may experience symptoms that include floaters, distortion, and/or blurred vision. Microaneurysms are the earliest clinical sign of diabetic retinopathy. (See Clinical Presentat Continue reading >>

Diabetic Eye Disease: Diagnosis, Causes, And Symptoms

Diabetic Eye Disease: Diagnosis, Causes, And Symptoms

By Debra A. Sokol-McKay, MS, CVRT, CDE, CLVT, OTR/L, SCLV Diagnosing Diabetic Eye Disease How Diabetes Affects the Eyes and Vision: Diabetic Retinopathy Eye Examination Guidelines Diagnosing Diabetic Eye Disease Diabetic retinopathy usually has no early warning signs. It can be detected only through a comprehensive eye examination that looks for early signs of the disease, including: Leaking blood vessels Macular edema (swelling) Pale, fatty deposits on the retina Damaged nerve tissue Any changes to the retinal blood vessels To diagnose diabetic eye disease effectively, eye care specialists recommend a comprehensive diabetic eye examination that includes the following procedures: Distance and near vision acuity tests A dilated eye (or fundus) examination, which includes the use of an ophthalmoscope. In a dilated eye examination, it is the pupil that is dilated—not the entire eye. This allows the examiner to see through the pupil to the retina. Visual acuity tests alone are not sufficient to detect diabetic retinopathy in its early stages. A tonometry test to measure fluid pressure inside the eye. A fluorescein angiography test, if more serious retinal changes, such as macular edema, are suspected. Fluorescein angiography is an eye test that uses a special dye and camera to look at blood flow in the retina. Optical coherence tomography (OCT) testing may be used to gain a clearer picture of the retina and its supporting layers. OCT is a type of medical imaging technology that produces high-resolution cross-sectional and three-dimensional images of the eye. Also, an Amsler Grid test can detect early and sometimes subtle visual changes in a variety of macular diseases, including diabetic macular edema. The first image below shows an Amsler Grid as seen with unimpaired vis Continue reading >>

Diabetic Retinopathy Screening And Tests

Diabetic Retinopathy Screening And Tests

Tweet A once yearly retinal screening appointment (eye check) is carried out to identify early signs of diabetic retinopathy. If allowed to develop, diabetic retinopathy can lead to blindness. For this reason it is important to attend your retinal screening once a year. Do I qualify for diabetic retinopathy screening? Everyone with diabetes who is 12 years of age or over should receive a retinal examination once a year as part of the NHS’s retinal screening programme. If you are concerned that you may be developing retinopathy, check for retinopathy symptoms and see your GP. Ask your GP or healthy centre if you have not received an invitation to have a retinopathy screening appointment. Who carries out the retinal screening? You may have the screening either at a hospital or you may be invited to book your appointment with an optician in your area. The screening is free regardless of where it takes place. What happens at the retinopathy screening? The optician will take a photo of your retina. To do this they will need to clearly see into as much of the back of your eye as possible. To enable them, to do this they will give you eye drops which will expand your pupils. It may take up to 20 minutes for the pupils to get large enough. The eye drops can sting a bit so just be ready. Try to keep your eyes open as best you can to avoid having to having to have additional attempts. The fluid needs to cover the centre of your eye to make your pupils larger. When your pupils are sufficiently expanded the optician will sit you down in front of a machine which will take the photograph of the retina in each of your eyes. Your eyes must be fully open for a good photograph to be achieved. Be aware that it may take a few attempts to get the photograph just right. As well as taking a Continue reading >>

Diabetic Retinopathy: Diagnosis, Prevention And Treatment

Diabetic Retinopathy: Diagnosis, Prevention And Treatment

Diabetic retinopathy: diagnosis, prevention and treatment Diabetic retinopathy: diagnosis, prevention and treatment Diabetic retinopathy: diagnosis, prevention and treatment Nearly 26 million Americans have diabetes, including types 1 and 2.1 All people with diabetes are at increased risk of complications over time, including a cluster of eye disorders such as cataracts, glaucoma and diabetic retinopathy. Diabetic retinopathy is the most common eye disorder in people with diabetes and is a primary cause of blindness in adults. People with both type 1 and type 2 diabetes are at risk for diabetic retinopathy and as many as 40% to 45% of patients diagnosed with diabetes have some degree of diabetic retinopathy.2 In fact, during the first two decades of illness, nearly all patients with type 1 diabetes, and more than 60% of patients with type 2 diabetes will have retinopathy.3 Retinopathy is a condition caused by damage to the small fragile blood vessels in the retina. Like many progressive disorders, diabetic retinopathy can be classified into subcategories ranging from the milder nonproliferative diabetic retinopathy to the more serious proliferative diabetic retinopathy depending on the extent of blood vessel damage. Diabetic retinopathy can result in blocked, swollen and leaky retinal blood vessels. New vessels may grow on the retina itself and in vitreous, the gel-like fluid in the back of the eye. Over time, damage from broken blood vessels leads to bleeding in the eye causing blurry vision, vision loss and even blindness. Vision loss may also result from glaucoma or retinal detachment. With diabetic retinopathy, vision impairment may also be linked to a comorbid condition known as macular edema, which occurs when fluid fills the eye's macula causing it to swell. Mac Continue reading >>

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